A lunchroom at Oscar Health, which offers a catered lunch for employees a few times a week, at the startup insurer's offices in New York, May 23, 2016. (Richard Perry/The New York Times)
Staff should be consulted on changes to their canteen menus © NYT/Redux/eyevine

In January, the 97 staff at the housing association South Liverpool Homes treated themselves to spa days, golf lessons, new trainers and membership of weight loss programmes. And their employer picked up the bill.

This was not a one-off display of festive generosity but part of a wellbeing strategy run by the not-for-profit company. It gives all staff a £200 ‘wellbeing payment’ once a year and the only condition is that they must spend it in a way that keeps them happy and healthy.

Kristene Karaski, a welfare and benefits officer at the organisation, says the wellbeing payments are very popular. “You can spend it on whatever’s applicable to you,” she says. “I do a lot of running, so I use the wellbeing payment for physiotherapy. Someone who’s not as active could have, say, spa treatments. They’re not being pigeonholed into activity and exercise; they’re using it in a way that makes them feel good.”

The payments raise awareness of health and wellbeing among staff, and help create a more engaged and motivated workforce, she says.

They also address one of the pitfalls of many companies’ attempts to improve the wellbeing of their workforce: how to raise low levels of employee engagement.

Some 79 per cent of services and facilities offered by companies to improve employee health have a low “awareness rate”, meaning that fewer than half of staff know that the benefit is available, according to figures from Britain’s Healthiest Workplace, the survey run by health insurer Vitality and research institute Rand.

Even more of these services suffer low take-up rates. Vitality’s figures, covering 112 companies and 32,538 employees surveyed last year, show 92 per cent of health and wellbeing services offered by employers had a “participation rate” of under 50 per cent.

The latest Vitality analysis, carried out this year and based on 169 employers and 34,182 employees, found that just 28.8 per cent of staff at large companies offering discounted gym membership were aware of this offer. Of those, 28.7 per cent took it up.

Lunchtime jogger runs past hoarding with London Bridge in the background. (Photo by In Pictures Ltd./Corbis via Getty Images)
Companies have started rewarding employees for having a healthy lifestyle © Corbis/Getty

Healthy options in the staff canteen, bicycle purchase schemes and clinical screening services all had awareness rates of less than 50 per cent, according to the study, which defined large companies as those with at least 1,000 employees.

By contrast, 100 per cent of SLH employees spent their wellbeing payment last year, according to the organisation’s HR director Colin Gibson.

Without handing out extra payments, there are other ways for companies to win employees over to their health and wellbeing strategies.

The simplest method, often overlooked, is making sure staff are aware of what is available to them.

“I speak to a lot of companies and ask them what they’re doing [about health and wellbeing],” says Louise Aston, wellbeing director at UK-based charity Business in the Community. “A lot of them are doing much, but it’s just not communicated in an effective way so many staff aren’t even aware of what’s on offer.”

When a company provides a particular service or benefit, shouting word of it from the rooftops, through emails to staff, a strong presence on the company intranet, company-wide branding of wellbeing programmes and so on, would be a step in the right direction, she says.

Recent data show once employees are aware of a company programme — for example, regarding nutrition or aids for physical exercise — employee participation and health improvement rates tend to be high.

Matthew Lawrence at insurer Aon Hewitt, says employers should go further by sending specific messages to certain groups of employees. “We’re seeing more activity around targeting communications,” he says. This includes identifying staff who are at risk of ill health because they are not taking a sufficient break from work: “If a company sees people selling back a lot of holiday time, it could send them a message saying, ‘it’s great that you’re taking the opportunity to sell holiday, but think about the importance of having a healthy work-life balance’.”

Asking employees what they want from a wellbeing programme is another vital step — and some companies find trade unions to be an important partner.

Peter Simpson, chief executive of Anglian Water, says unions — which represent about 40 per cent of his 4,500-strong workforce — have played an important role in developing the utility’s wide-ranging health and wellbeing strategy, which includes health checks, mental health training, alcohol awareness and weight loss programmes.

A health and safety committee made up of union members and other staff representatives helps determine the company’s approach and is responsible for approving it. “One of the risks of this stuff is, it can come across as paternalistic — it can come across as a bunch of perfectly fit individuals telling other people what to do,” Simpson says.

“But we’re on precisely the same page as the unions on this. That reinforces to employees that there’s not an ulterior motive. It gives employees confidence in it.”

Hugh Robertson, senior policy officer for health and safety at Britain’s Trades Union Congress, which represents 51 trade unions, says programmes developed without workforce engagement “will make people suspicious”.

“It can feel patronising, like the employer knows best; for example if they remove bacon and eggs from the staff canteen and replace it with healthy cereal.”

Unions, he adds, are often willing to be constructive partners: “If [health promotion] is done positively, with the workforce, it can be great, and can make a difference.”

FT staff play football during a lunch break. Photographed for Peter Chapman health special report.
Asking employees what they want from a wellbeing programme is a vital step © Charlie Bibby

Employers for their part should be prepared to rethink the way their organisation is run on the basis of employees’ input into health and wellbeing strategies. After realising stubbornly high absence rates were linked to workplace stress, North Star, a Stockton-on-Tees housing association, gave its officers smaller, more manageable areas to oversee, along with better training to manage disagreements with colleagues.

Jayne McDonald, a North Star housing officer, says such changes are more valuable than conventional health programmes. “If you have discounted gym membership but you still have all of the day-to-day stress, you’re not happy,” she says.

Leadership is essential. “If you’re a leader you’ve got a responsibility to be a role model,” says Rachel Suff, policy adviser at the Chartered Institute of Personnel and Development. “If you say wellbeing is really important, that’s a powerful message.”

For Anglian Water chief executive Simpson, leading from the top is personal. He lost a stone and a half (9.5kg) by joining a company-wide weight loss advice and support programme called “biggest loser”.

“It was a genuine opportunity for me [to lose weight],” he says. But it also sent a clear message to staff that he was personally committed to the company’s attempts to improve their health. “That enabled people to have conversations with, for instance, the canteen about making sure there were healthy options, and to challenge why some things hadn’t changed enough,” he says.

Positive signals from the top must be backed up by proper training and resources to enable middle managers to encourage health and wellbeing, says Andre Spicer, professor of organisational behaviour at Cass Business School in London. He warns that this can be tricky. “They [middle managers] are at the tough end, juggling multiple demands,” he says. “They’re given demands that their team performs. So demands to comply with wellness initiatives can come down as just one more thing to do.”

Explaining the business case behind workplace health and wellbeing is an important way to get line managers on side. “We know that employee engagement and wellbeing are inextricably linked; it’s now broadly understood that one without the other can lead to burnout,” says BITC’s Aston. A further step would be to include health and wellbeing measures in companies’ business objectives, with line managers — among others — held to account for meeting them, she suggests.

Offering incentives or rewards for healthy behaviour can significantly raise participation once programmes are in place. Vitality and Rand Europe studied 17 UK companies that introduced rewards for participation in health and wellbeing programmes and found that, on average, the number of employees taking part rose by 12 per cent in 2014-15.

“What’s supporting this is a huge amount of research around behavioural economics,” says Vitality’s director of strategy Shaun Subel. “In health and wellness, even with perfect information, people still behave in irrational ways. And that’s where the incentives can come in.”

Percentage of staff with nutritional services and benefits (large companies surveyed)
Access Awareness rate Participation rate Health improvement rate
Access to fresh drinking water 89.5 49.2 97.7 78.4
Access to a fridge 90.6 54.9 84 70.5
Access to a microwave 86.1 54.7 75.7 60.1
Fresh fruit and vegetables in the workplace 76.5 33.7 80.5 79.2
Healthy food alternatives at canteens 81 36.3 75.8 74.7
Healthy eating information 81.5 32.1 51 69.2
Healthy food alternatives in vending machines 35.9 18 57.5 76.8
Dietician/nutritionist services 36.6 8.3 29.1 82.7
Access : Percentage of employees who have access to a particular wellness service or benefit through the workplace
Awareness rate: Percentage of employees who are aware that their organisation offers a particular service or benefit
Participation rate: Percentage of employees who use the service or benefit when they know it is offered
Health improvement rate: Percentage of users who feel that the service or benefit has a positive impact on their health
Source: Britain’s Healthiest Workplace

Health insurer Bupa, as part of its offering to companies, gives employees discounts on wearable fitness devices to stimulate an interest in health and wellbeing programmes.

However, it does not link such incentives to actual activity levels. Beth Robotham, the company’s UK head of business development, says data from the US, where incentives are more widely used, suggest incentives can have “mixed results”.

“It comes down to different types of people and how they are motivated,” she says, adding that the use of incentives may not help employers “get to the unengaged, the people that need help with weight loss and their mental health”. Tailored support and mentoring may be more appropriate in these cases, she suggests.

Robotham says health and wellbeing programmes should be communicated to staff in a way that shows they are “about people and the things they’re interested in, and not just about what the business is interested in”.

This has proven effective at South Liverpool Homes, where staff are making plans to spend their next £200 wellbeing payment, due in January. As they do so, it emerges that they do not see themselves as participants in an employee wellbeing programme at all — although the payments are part of a broader programme that includes lunchtime walks, easy access to an external nutritionist and training for managers to talk routinely to staff about wellbeing. Rather, Karaski talks of a “culture” in which staff are “looked after”.

Perhaps the lesson here is that, though most employee health and wellbeing programmes are designed with business benefits such as reduced sickness rates and improved employee engagement in mind, employee buy-in rises when such programmes have the look and feel not of a human resources strategy, but of a perk.  

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